Physical Therapy Just as Effective as Surgery for Degenerative Disc Disease

Friday, October 11, 2013

Physical Therapy Just as Effective as Surgery for Degenerative Disc Disease

Physical therapy and other nonoperative treatments are just as effective at reducing pain and disability as surgical spinal fusion for patients suffering from degenerative disc disease (DDD), according to a recently published study conducted at Thomas Jefferson University Hospital in Philadelphia.

Results of the study, which were published ahead of print in World Neurosurgery, show that among 96 patients treated for DDD, there were no significant differences in outcomes between the 53 who were treated with lumbar fusion and the 43 who chose to pursue nonoperative treatment. Measured outcomes included pain, health status, disability, and overall satisfaction. All patients were cared for by the same physiatrist.

All of the subjects in the study received a diagnostic lumbar discography procedure between 2003 and 2009, and were offered fusion surgery based on the discogram and magnetic resonance imaging (MRI) results. Researchers found that while all patients reported significantly lower pain scores, data for the 2 groups "do not demonstrate a significant difference for standardized outcomes measures of pain, generalized health status, satisfaction, or disability."

Results from an APTA survey found that 61% of Americans experience low back pain, but only 4 in 10 seek relief through movement. The APTA patient-focused Move Forward website offers a host of low back pain resources for physical therapists (PTs) and their patients, including audio presentations and an e-book on low back pain and how PTs can help. Treatment of low back pain was the subject of a 2-day series of presentations at the 2013 APTA Conference in Salt Lake City in June, as well as the focus of several CEU courses in APTA's Learning Center.

Comments

This is a good evidence to prove to the patient that he/she should take the conservative ways of treatment before considering to undergo surgery.
http://www.rehabexperts.com.ph

Posted by Roland Villas -> BKYa?O
on 10/11/2013 9:21 PM

This is a good reminder that we should certainly look at alternative approaches that are less costly and less risky. We need to help our patients realize that studies like this show that surgery is not the treatment of choice in probably most cases. And a little patience will go a long way in seeing good results. However, without my being able to access this actual study for the details of the evidence, I wonder if we need to be cautious with the actual interpretation of this study, and correlative studies, as being the title of this article.

Posted by Ed Dieringer, PT
on 10/15/2013 11:13 AM

As a result of PT I escaped the need for neck and back surgury. I really support this study from personal experience.

Posted by Diana C. Sucich
on 10/17/2013 7:20 PM

Since the results of this study were posted in October, 2013, I'm wondering about the long-term results of PT vs. surgery. I have DDD and have already lost 2 1/2 inches in height due to it, have floating bone chips in my lower spine and a cyst growing there as well. How effective is PT for a person with those problems? The doctor I was seeing prescribed pool therapy (3 x week, 6 weeks), didn't want to see any new MRI results, and waved me off dismissively when I asked if I should see him when the pool therapy was done. I wonder if he even knows he raised his his voice to me when he angrily said "I'm not doing any surgery on you"...when in reality I had not even mentioned surgery. I had merely been following his instructions to have three epidurals done (they were not effective), and then to see him to determine what to do next. If I ever see another spine specialist, it won't be him, he made it obvious he was not interested in seeing me at any point in the future. I actually seriously doubt if I will ever see another spine specialist, or any doctor at all except my primary care, and there only to renew what few prescriptions I take.